Acute neurotoxicity in children treated for acute lymphoblastic leukaemia – a case series and review of literature

Complications of paediatric acute lymphoblastic leukaemia therapy in a notable number of patients include acute neurotoxicity, which presents most often as cerebrovascular disease, infection or a variety of nonspecific neurologic signs and symptoms, as well as recognizable clinical- radiological syndromes, due to admistered chemo- and radiotherapy. Although acute neurological events are rarely fatal, they usually present as emergency situations, often require treatment postponement and modifications, and can be followed by permanent sequelae in the form of epilepsy or cognitive dysfunction. We present three cases of acute neurotoxicity in childhood leukaemia patients treated at our department. Based on clinical presentation, laboratory and radiological findings, these cerebral events were characterized as ischaemia of the brain, posterior reversible encephalopathy syndrome and brain oedema with syndrome of inappropriate secretion of antidiuretic hormone. Timely and appropriate management resulted in complete neurological recovery in all three patients. Key words: LEUKEMIA, LYMPHOID; CENTRAL NERVOUS SYSTEM; NEUROTOXICITY SYNDROMES

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